E Appendix 4

Declaration for Foreign Students Applying to NKUHT

I herebyattest that I am qualified to apply for admission as a foreign student under the "Regulations Regarding
International Students Undertaking Studies in Taiwan' of the Ministry of Education, Republic of China
(RO.C).
2. *AF Ihereby attest that I fulfill one of thefollowing five conditions (check
the one that applies to you):

Iholdforeign nationality and have never held R.O.C. nationality. At the time of application, I do not
hold Overseas Chincse student status.

Ihold both foreign and R.O.C. nationalities and have never had houschold registration in Taiwan.
Moreover, I have resided continuously overscas for more than six ycars at the time of application,
have never studicd as an Overscas Chinese student in Taiwan and have not been approved for student
status by the University Entrance Committee for Overseas Chinese Students in the current academic
year.

Ihold foreign nationality, once had R.O.C. nationality, and eight years have clapsed since the
Ministry of the Interior revoked my ROC nationality from the date of application. Moreover, I
have resided continuously overseas for more than six years at the time of application, and have not
been approved for student status by the University Entrance Committee for Overseas Chinese
Students in the curent academic year.

Ihave foreign nationality and have permanent residence status in Hong Kong or Macau and have no
previous household registration in Taiwan, and have resided continuously in Hong Kong, Macau or
overseas for more than six years at the time of application.

Iwas from the mainland China region previously, have foreign nationality, have no previous houschold
registration in Taiwan, and have resided continuously overseas for more than six years at the time of
application.
 The academic certificates that I hold are recognized by the Ministry of Education and verificd by a Taiwan
overscas representative office. Distance-learning courses do not tolal more than halfof the total credits
obtaincd as required under the degree. Ialso promise to submit one copy of the foreign academic certificates
(or academic certificates sealed in an envelope by the original school), transcripts of all ycars (or transcripts as
scaled by the original school) as verificd by a Taiwan overscas representativc office at the time of admission
registration, and immigration records issued by a compctent immigration authority. If the documcnts are not
submitted on time or do not comply with thc application conditions of NKUHT, I will voluntarily give up the
admission qualification and shall make no objection.

4. * F Y T t *#it+#
R&kAL i

Ihave never completed a high school degree as a foreign student in Taiwan nor have I ever been
expelled from any college or university in the Republicof China. If there is a breach of this provision, I
understand that my admission qualification and student status shall be revoked.

Iconfirm that I have never studied in Taiwan as an Overseas Chinese student. If a competent authority
verifies my identify as being an Overseas Chinese student, my enrollment status shall be rescinded, and
Ishallnot voice any objections.

All relevant information provided (including the original and photocopy of academic qualifications, passport
and other relevant documents) is based on legal and valid documents. If there are any irregularities or
alterations, the admission qualification shall be revoked when substantiated by investigation, and no related
academic credits shall be issued.

After the admission grant has been obtaincd, the original diploma and transcripls, as verified by a Republic of
China (Taiwan) overscas unit or representative office (with certification stamp), shall be submitted at the time
of registration before enrollment. If the certificates are not submitted on time or found to be inconsistent with
the provisions of the "Regulations Regarding the Assessment and Recognition of Foreign Academic
Credentials for Institutions of Higher Education" of the Ministry of Education of the Republicof China, the
admission qualification shall be rovoked by NKUHT without any objection.

Ifulfill one of the following criteria :

I have submitted original proof or a photocopy of my academic credentials that have been verified by
a Republic of China overseas unit or relevant regulatory unit.
 Ihave applicd for admission to this schoolwith the academic credentials and transcripts that have been
verified by the Republic of China's Ministry of Education for a senior high school diploma/university
degree/master's degree from Ihereby guarantce that once accepted for ad1mission to the
university, Iwill submit the original academic credentials and transcripts verificd by an overscas agency
of the Republic of China or related entity to NKUHT's International Exchange Section of International
Affais Oflicc iy Sp 0, 2026 Failure to submit the documents on schedule or if there are any
discrepancies in regards to conformity to the ROC MOE's regulations relevant to degree verification will
result in a canceling of admissions eligibility to the university. I shall not voice any objections. (Please
be sure to tick if your documents have not been verified).

I hercby attest that I have read all of the above and that I fully understand the contents of this declaration.

Signatory of Declaration

TAE203521
Passport number

Date: 2D26 | O1 / 27 (Year/Month/Day)